1
|
Briggs LG, Labban M, Ye J, Herzog P, Jones AN, Nguyen DD, Wallis CJD, Wolter C, Porten S, Trinh QD. Predicting Peak Productivity in Urologic Medicare Practice via Work-Relative Value Units. Urology 2024; 191:1-8. [PMID: 38648950 DOI: 10.1016/j.urology.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To explore factors associated with productivity in urologic practice. Work-relative value units (wRVUs), the basis for Center for Medicare & Medicaid Services (CMS) and private payer reimbursements, commonly serve to estimate physician productivity. Limited data describes which practice factors predict increased wRVU productivity. METHODS The 2017 and 2018 CMS databases were retrospectively queried for urologic Medicare provider demographics and procedural/service details. Medical school graduation year was used to estimate years in practice and generation (Millennial, Gen X, Baby Boomer, or Post-War). Treated patients' demographics were obtained. Adjusted and unadjusted linear mixed models were performed to predict wRVU production. RESULTS Included were 6773 Medicare-participating urologists across the United States. Millennials produced 1115 wRVUs per year, while Gen X and Baby Boomers produced significantly more (1997 and 2104, respectively, P <.01). Post-War urologists produced numerically more (1287, P = .88). In adjusted analyses, predictors of Medicare wRVU productivity included female and pelvic medicine and reconstructive surgery (exponentiated beta estimate (β) 1.46, 95% CI 1.32-1.60), men's health (β 1.22, 95% CI 1.13-1.32), and oncologic subspecialization (β 1.08, 95% CI 1.02-1.14), female gender (β 0.87, 95% CI 0.82-0.92), wRVUs generated from inpatient procedures (β 1.08, 95% CI 1.06-1.09) and office visits (β 0.88, 95% CI 0.87-0.89), and the level of education (β 1.10, 95% CI 1.07-1.14) and percent impoverished patients (β 0.85, 95% CI 0.83-0.88) in provider's practice zip code. CONCLUSION Urologic experience, specialization, demographics, practice patterns, and patient demographics are significantly associated with wRVU productivity in Medicare settings. Further work should incorporate quality metrics into wRVUs and ensure patient demographics do not affect reimbursement.
Collapse
Affiliation(s)
- Logan G Briggs
- Department of Urology, Mayo Clinic, Phoenix, AZ; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Muhieddine Labban
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jamie Ye
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Peter Herzog
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alyssa N Jones
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - David-Dan Nguyen
- Division of Urology, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Sima Porten
- Department of Urology, University of San Fransisco, San Fransisco, CA
| | - Quoc-Dien Trinh
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
2
|
Nam CS, Daignault-Newton S, Kraft KH, Herrel LA. The Future is Female: Urology Workforce Projection from 2020 to 2057. Urol Clin North Am 2023; 50:501-513. [PMID: 37775209 DOI: 10.1016/j.ucl.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Multiple estimates have approximated a urologist shortage per capita of around 30% by 2030. In the context of the impending urologic workforce shortage, it is critical to have a nuanced understanding of the degree of workforce shortage in comparison with the US population to mitigate the negative downstream effects in the future. In continued growth and stagnant growth projection models, we found that female urologists make up a significant proportion of the workforce growth over the next four decades. This projection highlights the need for purposeful recruitment, structural changes, and advocacy among urology leadership to support and retain female urologists.
Collapse
Affiliation(s)
- Catherine S Nam
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI, USA.
| | | | - Kate H Kraft
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI, USA
| | - Lindsey A Herrel
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
3
|
Allyship for women in urology. Nat Rev Urol 2023:10.1038/s41585-023-00751-0. [PMID: 36894715 DOI: 10.1038/s41585-023-00751-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
|
4
|
Adams EJ, Louters MM, Kocsuta VA, Ganesh MB, Jang A, Ansbro B, Thavaseelan S, Kielb SJ. Gender Disparities and Differences Among Urologists Included in Top Doctor Lists. Urology 2023; 173:215-221. [PMID: 36455680 DOI: 10.1016/j.urology.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To understand gender trends among urologists included in "Top Doctor" lists as more women practice urology, we (1) Evaluated whether Top Doctor lists reflect a contemporary distribution of urologists by gender; (2) Describe regional differences in gender composition of lists; (3) Report similarities and differences among men and women Top Doctors. METHODS All urologists in regional Top Doctor Castle Connolly lists published in magazines between January 1, 2020 and June 22, 2021 were included. Physician attributes were abstracted. American Urological Association (AUA) census data was used to compare the number of men and women Top Doctor urologists to the number of practicing men and women urologists within each list's zip codes. Log odds ratios (OR) and (95% confidence intervals) were used to compare likelihood of list inclusion by gender overall and by region. RESULTS Four hundred and ninety-four Top Doctor urologists from 25 lists were analyzed, of which 42 (8.50%) were women. Women urologists comprised 0%-27.8% of each list, with 7 lists (28.0%) including zero women urologists. Using AUA census data, OR for list inclusion of men urologists compared to women was 1.31 (1.01, 1.70) overall, with OR = 0.78 (0.36, 1.72) in the West, OR = 1.39 (1.03, 1.89) South, OR = 1.46 (0.8, 2.67) Northeast, OR = 1.90 (0.50, 7.18) Midwest. Women top urologists completed fellowship more often than men (66.7%, 55.1%) and were significantly more likely to complete female pelvic medicine and reconstructive surgery (FPMRS) fellowship (P <.001). CONCLUSION Men urologists were significantly more likely to be included in Top Doctor lists than women urologists. Top women urologists were significantly more likely to complete FPMRS fellowship.
Collapse
Affiliation(s)
- Elizabeth J Adams
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Marne M Louters
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Victoria A Kocsuta
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Meera B Ganesh
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Angie Jang
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Brandon Ansbro
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Simone Thavaseelan
- Division of Urology, Brown University School of Medicine, Providence, RI
| | - Stephanie J Kielb
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
5
|
Findlay BL, Bearrick EN, Granberg CF, Koo K. Path to Parity: Trends in Female Representation Among Physicians, Trainees, and Applicants in Urology and Surgical Specialties. Urology 2023; 172:228-233. [PMID: 36495948 DOI: 10.1016/j.urology.2022.11.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/19/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To characterize recent trends among practicing female surgeons, surgical trainees, and surgical residency applicants to assess potential progress toward gender parity. METHODS Workforce statistics on U.S. practicing surgeons, trainees, and applicants among 9 surgical specialties were obtained from the Association of American Medical Colleges and Electronic Residency Application Service public databases. Physician and trainee data during 2007-2019 and residency applicant data during 2016-2020 were analyzed by surgical specialty. We used Cochrane Armitage trend tests to assess changes over time. RESULTS Female practicing urologists increased 104% during the study period, the third-largest increase among 9 surgical specialties (range 36%-114%, all P < .01), representing continued growth in the prevalence and proportion of women among surgical trainees in all surgical disciplines. In contrast, the overall change for female urology residents (28%) lagged significantly, ranking eighth among the 9 specialties (range 9%-149%, all P < .01), suggesting slowing growth in the training pipeline. Finally, while the proportional change in urology applicants has been significant (33%, P < .01), growth rates have markedly slowed in the past 5 years compared to women in practice and training since 2007. CONCLUSION While female representation among practicing urologists has improved relative to other surgical disciplines, declining rates of women entering and applying to urology residency suggest a longer trajectory toward gender parity.
Collapse
Affiliation(s)
| | | | | | - Kevin Koo
- Department of Urology, Mayo Clinic, Rochester, MN
| |
Collapse
|
6
|
Mehta A. Challenges Facing Women in Sexual Medicine. J Sex Med 2022; 19:1502-1505. [DOI: 10.1016/j.jsxm.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
|
7
|
Ukeje C, Elmasri A, Kielb S. Improving Gender Diversity in Urologic Residency Training. Curr Urol Rep 2021; 22:60. [PMID: 34913093 DOI: 10.1007/s11934-021-01074-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Women remain underrepresented in urology despite being well-represented in medicine overall. A more diverse urological workforce has the potential to lead to better health outcomes for patients. This paper presents an overview of barriers faced by women in urology at the student, resident, and attending level and potential solutions to mitigate these issues. RECENT FINDINGS Although the number of women entering urology has increased since the first woman became a board-certified urologist in 1962, women still are underrepresented, advance more slowly, and hold only a small percentage of leadership positions. Women in urology and surgical fields in general face numerous challenges and obstacles which can be improved to bring and keep more women in the field of urology. Recent efforts by both academic urologists and trainees themselves offer hope for change. Women in urology face challenges in the field which include more limited mentorship opportunities, harassment and bias, and 'pigeonholing'. Recent efforts by both academic urologists and trainees themselves offer hope for change to attract and keep more women in the field. These efforts include the American Urological Association's public commitment to advocating for and fostering a diverse and inclusive environment within urology. A more diverse urological workforce has the potential to lead to better health outcomes for patients, particularly in those populations where access to urological care may be limited.
Collapse
Affiliation(s)
- Chideraa Ukeje
- Department of Urology, Feinberg School of Medicine, Northwestern University, 676 N St. Clair, Suite 2300, Chicago, IL, 60611, USA
| | - Ayman Elmasri
- Department of Urology, Feinberg School of Medicine, Northwestern University, 676 N St. Clair, Suite 2300, Chicago, IL, 60611, USA
| | - Stephanie Kielb
- Department of Urology, Feinberg School of Medicine, Northwestern University, 676 N St. Clair, Suite 2300, Chicago, IL, 60611, USA.
| |
Collapse
|
8
|
Wenzel J, Dudley A, Agnor R, Bassale S, Chen Y, Rowe C, Seideman CA. Women are underrepresented in prestigious recognition awards in the American Urological Association. Urology 2021; 160:102-108. [PMID: 34153364 DOI: 10.1016/j.urology.2021.03.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine the proportion of women who received awards from the American Urological Association (AUA) and evaluate whether this has changed over time as the proportion of practicing female urologists has increased. METHODS A retrospective review of award recipients from the AUA website was performed. Gender of award recipient, type of award and year received were collected and the trend over time was compared with the AUA census. RESULTS Of the 622 award recipients, 43 (6.9%) were women. There was a larger proportion of women who received early career awards (15/65; 23.1%) compared to women who received more prestigious mid (1/44; 2.3%) or senior (27/513; 5.3%) career awards. Additionally, 17/43 (39.5%) of female award recipients were not clinical urologists, compared to only 33/579 (5.7%) of male award recipients. CONCLUSIONS Despite increased representation by women in the field of urology, women remain underrepresented in awards given by the AUA. Although the proportion of women receiving awards over time has increased, it remains less than expected given the increased proportion of practicing female urologists. Strategic initiatives should be employed to help advance women in academic urology.
Collapse
Affiliation(s)
- Jessica Wenzel
- Oregon Health and Sciences University, Department of Urology, Portland, Oregon 97239
| | - Anne Dudley
- Connecticut Children's Hospital, University of Connecticut Medical School, Division of Urology, Hartford, Connecticut 06106
| | - Rebecca Agnor
- Oregon Health and Sciences University, Department of Urology, Portland, Oregon 97239
| | - Solange Bassale
- Oregon Health and Sciences University, Department of Urology, Portland, Oregon 97239
| | - Yiyi Chen
- Oregon Health and Sciences University, Department of Urology, Portland, Oregon 97239
| | - Courtney Rowe
- Connecticut Children's Hospital, University of Connecticut Medical School, Division of Urology, Hartford, Connecticut 06106
| | - Casey A Seideman
- Oregon Health and Sciences University, Department of Urology, Portland, Oregon 97239.
| |
Collapse
|
9
|
Haslam RE, Collins A, Martin LH, Bassale S, Chen Y, Seideman CA. Perceptions of gender equity in pediatric urology. J Pediatr Urol 2021; 17:406.e1-406.e7. [PMID: 33558178 DOI: 10.1016/j.jpurol.2021.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION/OBJECTIVE Women constitute more than 50% of medical students in the United States. However, only 9.9% of practicing urologists are women, with much fewer numbers in high ranking appointments and positions of leadership. With a growing number of women in pediatric urology, we sought to evaluate how pediatric urologists perceive the climate for women physicians and compare perceptions and experiences of gender equity based on characteristics including gender, practice type, parental status, and years in practice. STUDY DESIGN An IRB approved survey was sent out to the Society of Pediatric Urology (SPU) listserve of active members. We utilized a validated study, the Culture Conducive to Women's Academic Success questionnaire (CCWAS, higher scores indicating better perceived culture toward women). Subcategories (equal access, work-life balance, freedom of gender bias, and leadership support) were also analyzed. A comment section was provided for respondents to include their own experiences. Descriptive statistics were used for demographics and clinical characteristics. Wilcoxon Rank-Sum and Kruskal-Wallace tests were used to compare CCWAS scores between groups. RESULTS A total of 116 practicing physicians returned completed surveys for analysis (response rate, 116/355 (33%) [ n = 41,35.3%] female [n = 75,64.7%] male). There was a statistically significant difference in total CCWAS score between male and female genders, indicating male physicians perceived the culture of their department toward women more positively than their female counterparts (median [ interquartile range] CCWAS score, 208.0 [189.0-228.0] vs 164.0 [136.0-190.3]; P < 0.0001). There was no significant difference in CCWAS scores based on years in practice, parental status, or academic versus private practice. DISCUSSION Limitations of our survey include both participation and non-response bias. Those with strong opinions may have been more likely to respond to the survey. Male respondents comprised 64.7% (n = 75) of overall respondents, representing 25% active male SPU members. Whereas the response rate of active female members of the SPU was 70%. The survey was designed to assess gender equity in academia, and may not be as generalizable to the private practice community. Yet, the differences in perceptions and experiences of gender equity of this study have been noted by studies in other specialties, as well as the 2018 AUA Census report, and may provide insight into the presence and perpetuation of unconscious or systemic biases within medicine. CONCLUSION In this study, male physician perceptions of gender equity were different from those reported by female physicians, suggesting there are gender-based differences in how gender inequities are perceived and experienced.
Collapse
Affiliation(s)
- Roxanne E Haslam
- Oregon Health and Science University 3303 SW Bond Avenue, CH10U, Portland, OR, 97239, USA.
| | - Austin Collins
- Biostatistics Shared Resources, Knight Cancer Institute, 2720 SW Moody Avenue, KCRB 4133 Portland, OR, 97201, USA
| | - Leigh H Martin
- Oregon Health and Science University 3303 SW Bond Avenue, CH10U, Portland, OR, 97239, USA
| | - Solange Bassale
- Biostatistics Shared Resources, Knight Cancer Institute, 2720 SW Moody Avenue, KCRB 4133 Portland, OR, 97201, USA
| | - Yiyi Chen
- Biostatistics Shared Resources, Knight Cancer Institute, 2720 SW Moody Avenue, KCRB 4133 Portland, OR, 97201, USA
| | - Casey A Seideman
- Doernbecher Children's Hospital, Oregon Health and Science University, 700 SW Campus Drive, Portland, OR, 97239 USA
| |
Collapse
|
10
|
Abstract
The future supply of urologists is not on pace to account for future demands of urologic care. This impending urologic shortage sits on a backdrop of multiple other workforce issues. In this review, we take an in-depth look at several pressing issues facing the urologic workforce, including the impending urology shortage, gender and diversity concerns, growing levels of burnout, and the effects of the coronavirus pandemic. In doing so, we highlight specific areas of clinical practice that may need to be addressed from a health care policy standpoint.
Collapse
Affiliation(s)
- Ryan Dornbier
- Department of Urology, Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA.
| | - Christopher M Gonzalez
- Department of Urology, Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA
| |
Collapse
|
11
|
Abstract
The presence of women in genitourinary (GU) specialty training and practice has lagged significantly behind other fields. Current challenges include maternity leave, sexual harassment, and pay disparities. Despite these obstacles, the prevalence of women in GU specialty training has risen rapidly. One consequence of retiring male providers and higher numbers of female graduates will be a notable demographic shift in the percentage of GU care provided by these younger women. It will be essential to anticipate and acknowledge the unique concerns of this workforce, particularly in light of the concomitant aging of the US population and the associated increase in demand for GU care.
Collapse
|
12
|
Solano C, Ortiz AMC, Jaimes LMB, Saavedra DXR, Ospino CO, Basto CS. Estado actual de las mujeres en la fuerza laboral en urología. Análisis bibliométrico. Rev Urol 2020. [DOI: 10.1055/s-0040-1721723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ResumenIntroducción Las mujeres han incursionado y aumentado en todas las áreas médico quirúrgicas y específicamente en la Urología, representando aproximadamente un 10% de esta fuerza laboral.Objetivo Describir el estado actual de las mujeres en la fuerza laboral en Urología a nivel mundial.Métodos Análisis bibliométrico basado en búsqueda retrospectiva de la literatura del año 1969 a 2019, mediante base de datos: MEDLINE, FABUMED y PubReminder®, utilizando términos de búsqueda: (workforce) AND (urology), incluyendo: artículos de revista, artículos originales de investigación, reseñas, ensayos y otros informes científicos. Se obtuvo el factor de impacto (FI) mediante Journal Citation Reports 2017/2018. A través de Scopus se obtuvo el h-index (HI). Las variables analizadas fueron: número total de publicaciones, revistas, autores, instituciones, porcentaje de publicaciones por revista y país, patrón de producción científica a lo largo del período estudiado. Se realizó análisis de mapeo bibliométrico con software VOSviewer®.Resultados Se encontraron un total de 352 revisiones desde el año 1969 hasta 2019. El mayor porcentaje de publicaciones fueron en la última década. Se encontraron en total 131 revistas, de ellas, 28 específicas de urología. La revista con mayor número de publicaciones fue el Journal of Urology. El 90% de los autores provienen de Estados Unidos y del total de artículos solo dos autores principales eran mujeres.Conclusiones El interés por determinar el papel de la mujer en la fuerza laboral urológica es reciente y se correlaciona con el aumento de la representación femenina en esta área.
Collapse
|
13
|
Nam CS, Daignault-Newton S, Herrel LA, Kraft KH. The Future is Female: Urology Workforce Projection From 2020 to 2060. Urology 2020; 150:30-34. [PMID: 32890624 DOI: 10.1016/j.urology.2020.08.043] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To project the size and demographics of the female urology workforce into 2060. METHODS We assessed current urology workforce estimates using 2019 American Urological Association Annual Census data. We used the Accreditation Council for Graduate Medical Education's Data Resource Book from 2007 to 2018 to determine the incoming urology workforce. With these inputs, we calculated urologic workforce projections using two stock and flow models. RESULTS In our continued growth model, the total number of urologists will be lowest in 2025 with 11,600 urologists and recover to baseline by 2040 with 13,377 urologists. The total number of female urologists will grow 3.77-fold from 2020 to 2060 with an absolute increase of 3,792 urologists. Comparatively, the total number of male urologists will grow 1.33-fold with an absolute increase of 3,996 urologists. In our stagnant growth model, the total number of urologists will be lowest in 2030 with 11,354 urologists and will not recover to baseline by the end of our projection. The total number of female urologists will grow 2.18-fold from 2020 to 2060 with an absolute increase of 1,615 urologists. Comparatively, the total number of male urologists will decrease by 21.5% with an absolute decrease of 2,579 urologists. CONCLUSION In the context of the impending urologic workforce shortage, female urologists make up a significant proportion of the workforce growth over the next four decades in both the continued growth and growth stagnant models. This projection highlights the need for purposeful recruitment, structural changes, and advocacy among urology leadership to support female urologists.
Collapse
Affiliation(s)
- Catherine S Nam
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | | | - Lindsey A Herrel
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | - Kate H Kraft
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI.
| |
Collapse
|
14
|
Halpern JA, Zumpf KB, Keeter MK, Tatem AJ, Kahn BE, Bennett NE, Welty LJ, Brannigan RE. National Characteristics of Surgeons Performing Vasectomy: Increasing Specialization and a Persistent Gender Gap. Urology 2020; 143:130-136. [PMID: 32325136 DOI: 10.1016/j.urology.2020.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/25/2020] [Accepted: 04/05/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe trends in the characteristics of urologic surgeons performing vasectomy over time. METHODS We performed a retrospective, cross-sectional study examining surgeon characteristics for case logs from the American Board of Urology between 2004 and 2013. We used generalized estimating equations with a log link and negative binomial distribution to examine demographic differences (gender, rural location, and surgeon volume) in the number of vasectomies surgeons performed over time. RESULTS Between 2004 and 2013, 5316 urologists had case logs collected within the 7-month certification window. The majority of these surgeons self-identified as general urologists (82.8%), and a small proportion identified as andrology and infertility specialists (1.7%). Across all years, the median number of vasectomies performed per certifying surgeon during the study period was 14 (interquartile range 6-26). The majority of vasectomies were performed by high-volume surgeons (≥ 26 vasectomies) ranging from 49.2% to 66.9% annually, whereas the proportion performed by low-volume (≤ 5 vasectomies) surgeons ranged from 3.3% to 6.6% annually. Male surgeons performed vasectomies 2.20 times more frequently than female surgeons (95% confidence interval 1.93-2.49; P <.0001) across the study period with no evidence to suggest this gap changed over time (gender-year interaction 1.01 [95% confidence interval: 0.97-1.06; p = .576]). CONCLUSION While the majority of urologists performing vasectomy identify as general urologists, there appears to be a focus on vasectomy practice among a small number of high-volume surgeons. Furthermore, while the number of female surgeons performing vasectomies increased, a gender gap persists in the proportion of vasectomies performed by females.
Collapse
Affiliation(s)
- Joshua A Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Katelyn B Zumpf
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Mary Kate Keeter
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | | | - Nelson E Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Leah J Welty
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
| |
Collapse
|
15
|
Breyer BN, Butler C, Fang R, Meeks W, Porten SP, North AC, Anger JT. Promotion Disparities in Academic Urology. Urology 2020; 138:16-23. [DOI: 10.1016/j.urology.2019.10.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/04/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
|
16
|
Contemporary Landscape and Strategies to Engage Women Urologists in Treatment of Male Sexual Function. J Sex Med 2019; 16:1119-1121. [DOI: 10.1016/j.jsxm.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/01/2019] [Accepted: 05/06/2019] [Indexed: 11/18/2022]
|
17
|
Cohen AJ, Ndoye M, Fergus KB, Lindsey J, Butler C, Patino G, Anger JT, Breyer BN. Forecasting Limited Access to Urology in Rural Communities: Analysis of the American Urological Association Census. J Rural Health 2019; 36:300-306. [DOI: 10.1111/jrh.12376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/18/2019] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Andrew J. Cohen
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Medina Ndoye
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Kirkpatrick B. Fergus
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - John Lindsey
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Christi Butler
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - German Patino
- Department of UrologyUniversity of California‐San Francisco San Francisco California
| | - Jennifer T. Anger
- Cedars‐Sinai Department of SurgeryDivision of Urology Los Angeles California
| | - Benjamin N. Breyer
- Department of UrologyUniversity of California‐San Francisco San Francisco California
- Department of Biostatistics and EpidemiologyUniversity of California‐San Francisco San Francisco California
| |
Collapse
|